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Gastric Bypass
Roux-en Y Gastric Bypass
(RYGB)
The RYGB combines restrictive and malabsorptive approach for an effective weight loss . The result is an early sense of fullness and reduced absorption of calories, combined with a sense of satisfaction that reduces the desire to eat.
The most important benefit of the RYGB, besides successful weight loss is its ability to improve and often eliminate the medical diseases associated with obesity in more than 90%. Diabetes, hypertension, as well as other medical problems are cured in a large majority of patients.
The RYGB is both a restrictive and a malabsorptive procedure. The restrictive part of the procedure is the creation of the small stomach pouch with a small outlet. The malabsorptive part of the procedure involves cutting and then re-arranging the proximal small intestine.
The first step is to create the pouch. The small stomach pouch is created using the stapler. The pouch created is under 30ml in size. The remaining stomach is left in place, but separated from the stomach pouch. The outlet from this newly formed pouch will empty directly into the bypass portion of the small bowel (roux Y).
The next step is dividing and then re-arranging the small bowel. This is done by dividing the small intestine about 1 to 2 feet from its origin. One cut end of the bowel is brought up to the pouch (roux Y). While the other cut end, is reconnected to the small bowel about 3 to 5 feet from the pouch. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.
The Roux-en-Y gastric bypass is the most frequently performed weight loss procedure in the United States . The national average expected weight loss with the RYGB procedure is around 70% to 80% of excess weight. About 50% of the expected weight loss will be lost in the first 6 months after the operation. The remaining half is lost slower over the remaining 12 months.
This procedure can be performed as an open or laparoscopically. Advantages of laparoscopic compared to open bypass include lesser blood loss, shorter hospitalization, reduced postoperative pain, faster recovery and fewer wound complications (incisional hernias and infections).
Gastric Bypass video
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